One Nation leader Pauline Hanson's
plan to combat Medicare fraud by placing photos on cards would cost half a
billion dollars and have limited effect, bureaucrats say.
The senator
introduced a private member's bill in February to stamp out "rorting" of
the health system that she said cost taxpayers millions.
She said there was
nothing to stop someone who did not qualify for free or subsidised medical
assistance from borrowing a card from a friend.
"It does
happen. When was the last time someone checked your ID when you used your
Medicare card? It has never happened to me," Senator Hanson said.
But the Department
of Human Services told a Senate committee examining the draft legislation the
idea had been estimated to cost $500 million when it was scoped several years
ago.
A Medicare
smartcard was piloted in Tasmania in 2004, attracting significant public and
media interest over privacy concerns.
Citizen uptake was
minimal and the pilot was discontinued, the department said.
The 2017 Shergold
review also looked at the idea and determined that while a photograph or
hologram might reduce Medicare card fraud in the short term, such changes were
not likely to have a lasting effect.
Fraud also appeared
to be rare; 84 cases were referred to the Commonwealth Director of Public
Prosecutions last financial year.
"This
represents a very small proportion of the 25.6 million Medicare
customers," the department said.
The Australian
Medical Association said the proposal would significantly add to the red tape
patients and providers already dealt with.
It pointed out
patients did not need to present their Medicare card when accessing health
services - their Medicare number was enough.
"This renders
the photograph on the front of the card useless," the association said.
The placement of
photos on Medicare cards presented another dilemma.
Up to nine people
can be included on one Medicare number, and up to five names on one individual
card.
"There is very
little remaining space on the front of a Medicare card when five names appear,
let alone for an additional five photographs," the AMA said.
"Multiple
photographs with enough clarity to enable identification would be exceptionally
difficult in these circumstances. There is a risk with unclear photographs that
a patient may be denied access to care, were it deemed by the service provider
that they did not match their photo, and could not confirm their identity
another way."
Photos of children
added to their parent's cards posed another problem.
"Medicare
cards are valid for five years, so by the time that infant is a toddler, their
appearance would be completely different to the photograph on the card,"
the AMA said.
"For them to
be reliably identified, replacement certified photographs would need to be
provided as the child's appearance changes. This adds another administrative
burden on busy parents and additional costs to the provider of the
photograph."
The department said
the number of Medicare cards would need to increase from 14.5 million to 25.6
million to accommodate individual cards with photos.
"The
department believes there are more effective and efficient ways to ensure the
integrity of Medicare into the future," officials said.
The Senate
committee is due to report back next week.
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